Early Cardiac Catheterizations within 30 Days Post Congenital Heart Surgery in Children

Abstract

Background: This study set out to assess the indications, feasibility, safety, and outcome of early cardiac catheterizations (CC) within 30 days after congenital heart surgery (CHS) in children. Methods and Results: This is a retrospective, single-center case review study of all CC within 30 days after CHS between 1/2010-12/2020. A total of 317 (138 diagnostic, 179 interventional) CC were performed in 245 patients at a median of 4 days (IQR 13) after CHS. The median age was 3 months (IQR 6), and body weight was 5 kg (IQR 4). A total of 194 (61.2%) CC were performed in patients with univentricular hearts. CC revealed significant pathologies leading to early redo-surgery in 37 patients (12%). The transcatheter interventions primarily were needed in patients after cavo-pulmonary connection (n = 69%, 21.8%), right ventricle to pulmonary artery conduit (n = 39%, 12.3%), and Norwood-I surgery (n = 34%, 10.7%) presenting with hypoxemia, prolonged postoperative course, and suspected arterial stenosis on echocardiography. The clinical impact of an early postoperative transcatheter intervention for the following clinical course was high in most cases. There were nine (2.8%) major and 20 (6.3%) minor intra-procedural complications. Risk factor analysis revealed no difference for the occurrence of complications for patients’ age, weight, and time from initial CHS, underlying uni- vs. biventricular heart disease, or ECMO. Conclusion: Early CC within 30 days after CHS in children can be performed safely with a high diagnostic and therapeutic value. The rate of complications is low, while the therapeutic consequence is relevant.